腓动脉穿支供血的腓肠神经营养血管逆行岛状皮瓣肌皮瓣临床应用  

CLINICAL APPLICATION OF THE DISTALLY BASED SURAL ISLAND FLAP AND MYOFASCIOCUTANEOUS FLAP

作　　者：沈余明[1] 向东[1] 王乃佐[1] 宓惠茹[1] 覃凤均[1] 陈辉[1] 沈祖尧[1] 

机构地区：[1]北京积水潭医院烧伤科,北京100035

出　　处：《中国修复重建外科杂志》2006年第3期256-258,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨腓动脉穿支供血的腓肠神经营养血管逆行岛状皮瓣、肌皮瓣在足踝部软组织缺损、骨感染修复中的效果。方法1997年6月～2004年10月,对21例足踝部软组织缺损及骨感染的患者,采用腓动脉穿支供血的腓肠神经营养血管逆行岛状皮瓣或肌皮瓣进行修复。其中男20例,女1例,年龄6～78岁。创伤致软组织缺损18例,电烧伤3例,其中足部贴骨瘢痕、骨髓炎4例。术中切取岛状皮瓣17例,肌皮瓣4例。皮瓣、肌皮瓣切取范围5cm×4cm～22cm×16cm。供瓣区拉拢缝合4例,游离植皮17例。结果术后21例皮瓣、肌皮瓣完全成活,创面期愈合。随访3～6个月,无任何并发症,皮瓣质地优良,外观满意,行走正常,术后皮瓣感觉恢复欠佳。结论腓动脉穿支供血的腓肠神经营养血管逆行岛状皮瓣、肌皮瓣为一可靠的皮瓣,切取方便,供瓣面积大,血供丰富且不牺牲主要动脉,是修复小腿中下部、踝关节周围及足部软组织缺损的一种良好方法。尤其对修复足踝部深洞状缺损、骨髓炎,肌皮瓣是一种较好的选择。Objective To investigate the clinical efficiency of the distally based sural island flap and myofasciocutaneous flap in reconstruction of defect and osteomyelitic cavity of the ankle and foot. Methods From June 1997 to October 2004, 21 patients with soft tissue defects and osteomyelitis in the ankle and foot were treated with the distally based sural island flap and myofasciocutaneous flap. There were 20 males and 1 female aging from 6 to 78 years. The defect was caused by soft tissue defect trauma（18 cases） and electrical injury （ 3 cases）. Among 21 patients, 17 were treated with island flaps, 4 by the myofasciocutaneous flap. The size of flaps ranged from 4 cm×5 cm to 16 cm× 22 cm. The donor sites were closed directly in 4 eases. Results The flaps completely survived in 21 cases and healing by first intention was achieved. After a follow-up of 3-6 months, no complication occurred. The color and texture of the flaps were good. The appearance and the function were satisfactory. Conclusion Distally based sural flap is a reliable flap. This flap has rich blood supply without sacrifice of major arteries. Flap elevation is easy. It is very useful in repairing large soft tissue defects of the lower leg, the ankle and the foot, especially in repairing deep soft tissue defects and osteomyelitic cavities .

关 键 词：腓肠神经 皮瓣 腓动脉肌皮瓣 足踝 修复 

分 类 号：R622[医药卫生—整形外科]